Insurance Claims Resume Samples
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Insurance Claims Resume Samples
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JZ
J Zemlak
Jamaal
Zemlak
5783 Werner Shore
Chicago
IL
+1 (555) 531 6539
5783 Werner Shore
Chicago
IL
Phone
p
+1 (555) 531 6539
Experience
Experience
Los Angeles, CA
Insurance Claims & Administrative Assistant
Los Angeles, CA
Hettinger-Marquardt
Los Angeles, CA
Insurance Claims & Administrative Assistant
- Assist with claim management, loss data collection, and financial tracking
- Provide department assistance under department director’s guidance
- Assist and carry out special projects as identified
- Manage U.S. certificate of insurance program for all Group brands
- Data management and spreadsheet software
- Proficient in English language (speaking, reading and writing)
- Proficient in Microsoft Office (Word, Excel, PowerPoint)
Chicago, IL
Insurance Claims Analyst
Chicago, IL
Klocko, Wisozk and Bode
Chicago, IL
Insurance Claims Analyst
- Manages claim process from initial filing by policyholder to decision
- Review insurance policies to establish and confirm coverage for claims
- Communicates expectations of file quality to franchisees including completeness and accuracy of Record of Drying conditions according to the S-500 standards established by the Institute of Inspection, Cleaning and Restoration Certification. Corresponds with franchisees, 866RECOVER (end user) clients, agents, policy holders, and insurance companies on claims and payment status
- Provide consultation before, during, and after claim occurs
- Submits claims within established guidelines for commercial and personal lines clients and insurance customers, and follows up on the status of all claim files with clients and requests monies due on all losses that analyst processes
- Reviews and analyzes mitigation claim reports based on standards including: correct invoicing of line items, psychrometric review of data in the record of drying conditions, correct labor efficiency, price list variation, equipment sizing, etc
- Design and review any changes for risk management accounts
present
San Francisco, CA
Insurance Claims Consultant
San Francisco, CA
Swaniawski and Sons
present
San Francisco, CA
Insurance Claims Consultant
present
- Access online resources. Develop and maintain library of resources for risk management practice group. Assist in compliance areas relating to claims and safety
- Support the implementation of comprehensive workers compensation management and risk control programs. Develop and support carrier claims relationships
- Attend client meetings as requested. Assist with the preparations of client presentations and training workshops
- Building and developing external business relationships
- End to end claims management
- Identify opportunities for process improvement
- Achieve monthly productivity level as designated by management
Education
Education
Bachelor’s Degree in Business
Bachelor’s Degree in Business
Rutgers University
Bachelor’s Degree in Business
Skills
Skills
- Understanding of insurance coverages related to Worker’s Compensation, Auto Liability and General Liability coverages
- Able to respond quickly and efficiently to last minute requests and respect deadlines
- Highly detail oriented
- Highly proficient in Power Point
- Highly proficient in Excel, including modelling complex graphs derived from data sets
- Strong desire to learn more about the global risk management industry
- Excellent spoken and written communication skills
- Proficient in Microsoft Office Suite, carrier hosted claim systems and other RMIS systems
- Ability to work independently as well as in a team environment
- Highly organized
15 Insurance Claims resume templates
Read our complete resume writing guides
1
Manager Sourcing, TD Insurance Claims Resume Examples & Samples
- Drive and deliver transformation of SSG and a step-change in procurement proficiency within the LOBs they support
- Assist in development and execute TDI Claims sourcing strategies for the each Stakeholder group that drive sustainable competitive advantage and concentrate spend with suppliers that matter to and value TD
- Drive value in supply chain/total cost of ownership sourcing initiatives through early engagement, commercial acumen and market knowledge. Activities also include requirements gathering, solution/supplier evaluations and supplier selection activities
- Proactively deliver, oversee and manage TDI Claims market intelligence activities including industry, supply market and supply chain research/analytics, category sourcing and outsourcing trends and best practices and share knowledge, insight and advice with business in a way that contributes to their long term business strategies
- Provide guidance and insight on outsourcing governance best practices and provide counsel to business to ensure supplier arrangements meet all TDBG policy and regulatory requirements
- Participate and represent the Bank at industry group meetings and/or supplier forums and maintain a wide referral network
- Foster strong collaborative relationships with partners in SSG (PRG&C, Category Leads etc), the business and TDI Vendor Management Office
- Proven experience in business planning and delivery of objectives
- Experience in project management and strong analytical skills
2
Senior Manager Sourcing, TD Insurance Claims Resume Examples & Samples
- As a member of the Category Leadership team, this dynamic individual will help to drive and deliver transformation of SSG and a step-change in procurement proficiency within the LOBs they support
- Proactively engage business leaders to understand their business strategies and objectives in order to align our work to help achieve them
- Manage a team of dedicated procurement professionals to meet stretching and valued objectives while developing, deepening and coaching the SSG talent pool
- As a people manager, create an environment that encourages growth, visibility and continual learning. Recognize and value individual differences and contributions; seek to include diverse and global perspectives
- Proactively manage the 3rd-party expenditure assigned and associated key suppliers to create P&L impacting value that is recognized by the business and organization
- Develop and execute TDI Claims sourcing strategies for the each Stakeholder group that drive sustainable competitive advantage and concentrate spend with suppliers that matter to and value TD
- Ensure effective delivery of Strategic Sourcing Group (SSG) procurement services to business partners and ensure prompt and thorough resolution of all client issues
- Foster strong collaborative relationships with partners in SSG (PRG&C,
- Category Leads etc), the business and TDI Vendor Management Office
- Proven experience managing and leading high performing teams
- Strong Microsoft Office skills, especially Excel, PowerPoint and Outlook
3
Insurance Claims & Administrative Assistant Resume Examples & Samples
- Process department and Group insurance related invoices
- Manage U.S. certificate of insurance program for all Group brands
- Reporting of claims to applicable adjusters and insurance broker
- Maintain electronic claim file registers for claim loss tracking
- Setting up and maintaining claim files for all lines of coverage
- Assist with claim management, loss data collection, and financial tracking
- Collect and organize due diligence information for policy renewals
- Provide department assistance under department director’s guidance
- Assist and carry out special projects as identified
- Analytical skills
- Organizational abilities
- Proficient in Microsoft Office (Word, Excel, PowerPoint)
- Three years’ experience in a fast-paced atmosphere
- Proficient in Microsoft Office Suite, and insurer provided intranet tools
4
Insurance Claims Resume Examples & Samples
- Take first notification of loss for all claims reported to team
- Gather maximum detail by contacting all parties involved
- Where possible confirm liability and indemnity
- Allocate reserves as per procedure
- Assign claim to the appropriate handler, where necessary
- Protect clients' expenditure within authority levels and complexity assigned and control the claim settlement time periods within client and company service levels
- Negotiate settlement of all aspects of property damage claims
- Maximise the recovery of client's outlay within authority levels and complexity assigned and control the claims settlement time periods within client and company service levels
- Determine and maintain up to date and accurate liability assessments
- Carry out basic suspected fraud investigations where required
5
Team Manager Group Insurance Claims Resume Examples & Samples
- Holistic Claims Management
- Customer Commitment
- Stakeholder Engagement
- Balancing Metrics & Quality
- Demonstrated experience in working with, or managing a team with specialised skills and function
- Demonstrated success in leading and managing operational teams in a customer facing environment and driving a collaborative, high performance culture
- Demonstrated experience managing Technical Claims functions and processes, leading teams across geographies and managing metrics to drive performance
- Relevant experience in customer resolution and complaints management
- High integrity and business ethics demonstrated
- Demonstrates an awareness of relevant commercial and socio-economic factors and influences when making claims management decisions and recommendations
- Demonstrated experience in implementing significant change across an operational business and delivering projects on time, to budget
- Relevant tertiary qualification/s or preparedness to undergo studies in business, insurance and/or finance desirable
- Qualification in case management, insurance or related medical field/s are considered advantageous
- Relevant experience in the financial services industry will be advantageous
- Relevant project or change management experience and/or qualifications will be highly regarded
6
Corp Insurance Claims Manager Resume Examples & Samples
- Oversee the case management, investigation, evaluation, tactics, strategy, negotiation, settlement authorization and payments of insurance liability claims and lawsuits
- Manage outside counsel activities for insurance auto and general liability lawsuits including the selection of counsel, hourly rates, billing services and case management plans and objectives
- Prepare, verify and assure the efficiency, accuracy and consistency for litigation discover requests (i.e. answers to interrogatories, production of documents and requests for admissions, etc)
- Attend arbitrations, mediations, pretrial conferences, depositions and other trial proceedings as is required, necessary or in the best interest of the organization
- Develop, implement, monitor and evaluate performance standards and claim services provided by insurance broker, insurance company and third party claim administrator
- Conduct audit of financial services including payments and reserves
- Oversee, supervise, directly handle or delegate to others all first party property damage claims and crime bond claims
- Oversee, supervise, directly handle or delegate to others all insured and uninsured property damage recovery (subrogation) claims
- Provide business continuity and recovery group and LOB catastrophe insurance services and provide analysis for crisis management and catastrophe planning
- Provide insurance coverage analysis for claims and policy administration and provide periodical reports, support and changes as is required
- Review and analyze safety, environmental, medical data and Medicare Section 111 compliance issues
- Assure quality and accuracy of information technology systems support
7
Insurance Claims Agent Resume Examples & Samples
- Responsible for customer service quality and service delivery to our customers in the claims area
- Through client contact, develop appropriate information to define nature of loss and determines if coverage is afforded. Work with all claims staff on these processes
- Act as a liaison with insurance carrier, identify level of adjustment - company, independent, or agency. Assign and follow up as appropriate. Responsible for company relations in the claims area
- Review adjustments by other parties; determine appropriate settlements. Expedite payment to claimant
- Maintain accurate accounting and statistical records associated with each loss using automated systems
- Maintain written automated claims procedures
- Create and maintain, as necessary, loss history on each account in the office
- High School graduate or equivalent
- Four years of insurance underwriting or claims experience
- Operates independently and can service the majority of clients and/or resolve most problems
- Demonstrated proficiency of basic computer skills, such as Microsoft applications
8
Insurance Claims Agent Resume Examples & Samples
- Is responsible for customer service quality and service delivery to our customers in the claims area
- May provide guidance and coaching to the more junior staff
- May act as a client advocate with carriers to ensure proper coverage
- High School graduate or equivalent education and related training
- Six years of insurance underwriting or claims experience
- Two years of claims management experience
- Fully experienced and capable of handling the most complex/challenging claims issues
9
Insurance Claims Team Lead Resume Examples & Samples
- Ability to read and interpret procedure manuals
- Must be organized and work well in a team environment
- Strong research, analytical and problem solving skills required
- Strong people skills a must
10
Insurance & Claims Technician Resume Examples & Samples
- High School Diploma or GED
- One year of experience in insurance claims processing, billing of verified services via claim form, verification of benefits and/or eligibility with various insurance companies and/or payers, research and review of complex issues and/or denials
- At least six months of experience with payment entry and reconciliation
- Experience billing health insurance, for example, Kaiser, Medicaid, various State agencies, Commercial Insurance, etc
- Experience in the health insurance arena (including billing of services via claim form, verification of benefits,review of complex issues, denials, payment entry and reconciliation)
- 10 key experience
11
Insurance Claims Collector Resume Examples & Samples
- 3+ years experience with collections, insurance, or relevant experience
- Degree in accounting, finance, business administration, or relevant experience
- Ability or willingness to be on the phone for several hours a day
- Experience in training
12
Insurance Claims Analyst Resume Examples & Samples
- Manages claim process from initial filing by policyholder to decision
- Serves as liaison between policyholders and insurance companies during claim process
- Maintains communication between clients and support team (account executives, producers, and CSAs)
- Provide consultation before, during, and after claim occurs
- Design and review any changes for risk management accounts
- Review all claims for any issues
- Schedule and participate in claim reviews between insurance companies and policy holders
- Provide large loss reports and error and omissions claim handling
- Maintain file documentation and claims tracking systems
- Excellent verbal, written, and interpersonal skills to interact with clients, carriers, and associates at all levels of responsibility
- Strong aptitude for interpretation of coverage forms, contractual agreements, and financial statements
- Proficient with Microsoft Word, Excel, and Outlook
13
Insurance Claims Examiner Resume Examples & Samples
- Applies insurance industry experience and judgment in making decisions for Life Insurance and Annuity Claims. Develops solutions to complex claims situations. Use sound judgment to make decisions and resolve issues
- Resolves complex issues escalated from less-experienced team members
- Interfaces with customers (beneficiaries, agents, policy holders) and internal departments in the resolution of complex claim problems and/or state specific regulation interpretation
- Probes beyond the stated situation to identify issues and potential risks. Communicate sensitive and confidential information
- Utilizes comprehensive knowledge of a wide range of procedures and products common to life and annuity claims
- Successfully manages pressure and impact of service level requirements for multiple clients
- Effectively communicates with management, clients, legal representatives and customers to expedite the adjudication process
14
Insurance Claims Consultant Resume Examples & Samples
- Produce loss runs from insurers’ on line systems. Review and interpret loss data relative to the clients’ insurance program
- Analyze data to identify loss trends and development of experience modification rates. Audit, analyze and project experience rates
- Compile data to draft clients’ loss summaries following agency’s templates. Draft claim summary reports following agency’s templates
- Phone and email contact on claims and with employer representatives and insurers/TPAs. Schedule and coordinate claim reviews with carriers, clients and claims consultants
- Access online resources. Develop and maintain library of resources for risk management practice group. Assist in compliance areas relating to claims and safety
- Support the implementation of comprehensive workers compensation management and risk control programs. Develop and support carrier claims relationships
- Responsible for proactive initiatives with clients based on service plan
- Attend client meetings as requested. Assist with the preparations of client presentations and training workshops
- Administer agency required office practices and procedures. Maintain information in the agency’s database
- Minimum of 2 years progressive property/casualty or workers compensation claims administration required. 4+ years preferred
- Extensive computer experience including Excel, Word, PowerPoint and ability to adapt to multiple web based carrier information systems
- Professional claims designation preferred but not required
15
Insurance Claims Agent Resume Examples & Samples
- Through client contact, develop appropriate information to define nature of loss and determine if coverage is afforded
- Act as a liaison with insurance carrier, identify level of adjustment -company, independent or agency. Assign and follow-up as appropriate
- Maintain and follow written automated claims procedures
- Three years of insurance underwriting or claims experience
- Good interpersonal skills, written and verbal
- Knowledge of and/or ability to learn Insurance Service's automation system (Sagitta)
16
Insurance Claims Supervisor Resume Examples & Samples
- Manage employee performance to achieve unit, department and corporate company goals
- Manage compliance requirements with claim handling guidelines and ensure good faith claim handling
- Conduct daily diary review
- Direct Adjusters on proper reserving and payments
- Monitor and report on performance of outside vendors
- Proactively assess claims processes to help develop strategies to seek continual improvement in our processes
- 5+ years personal lines claims adjusting, specifically Homeowner’s experience
- 4+ years proven supervisory experience
- Bachelor’s Degree a plus
- Ability to manage in a team oriented environment
- Effective verbal & written communication with internal and external customers of the claims department
- Creative thinking ability to recommend and help implement sound yet creative, claim related practices
- Positive attitude with ability to create and promote change
- Strong analytical and time management skills
17
Insurance Claims Examiner Resume Examples & Samples
- The Business Analyst role will involve working with Claims Insurance Clients independently on projects and systems related to the end-to-end processing of Claims for specific products and processes
- Conducts business process analysis, needs assessment and preliminary cost/benefit analysis in an effort to align business and/or technical solutions with business initiatives
- Considers and effectively communicates the business implications of process and technical solutions to support current and future business environments
- Evaluates and translates end user requirements and issues to technical associates and/or vendors where appropriate
- Develops, reviews and delivers end-user documentation using appropriate tools
- Helps to write/update standard operating procedures, while at the same time examining the existing SOP's for process improvements
- Works closely with the Claims team to support the achievement of Client Service Level Agreements, project milestones and delivers on internal/external commitments
- Works independently to gather information, adjusts to multiple demands and shifting priorities and accepts responsibility for results
- Must be self directed, and able to predict and define upcoming work initiatives
- Over time, the ability for the incumbent of this role to partner with the process improvement team to implement new processes is expected. This could include learning the basics of the Six Sigma methodology
18
Insurance Claims Intern Resume Examples & Samples
- Market competitive compensation
- Formal company orientation and training
- Executive speaking series
- Experienced mentors
- Hands on experience
- Project based work
- Leadership and career development
- Networking opportunities
- Attend formal company orientation and training
- Participate in executive speaking series
- Have hands on experience in area of study; as well as participate in project based work
- Communicate regularly with mentors
- Lead an end of assignment presentation
- Demonstrates a background and/or strong interest in the Financial Services industry
- A rising Junior or Senior in a full-time undergraduate program
- Maintain a GPA of at least 3.0
- Strong candidates will possess strong leadership, interpersonal and communication skills
- A passion for the financial services industry is strongly preferred
- Candidates should reside in a commutable distance from the Ally location to which they are assigned
- Eligible to work in the US for any employer without sponsorship from the company
19
Insurance Claims Coordinator Resume Examples & Samples
- Intake and triage of incoming claims reports and associated documents for distribution to the team
- Evaluation and oversite of medical only Workers’ Compensation claims (non-complex), to include working with TPA/Insurance Company to resolve claims in a timely manner
- Evaluate and process self-insured first and third party property damage claims
- Provide support to members of Human Resources, EH&S, Finance Departments, Location Managers and Administrative personnel regarding claims reporting, handling status and program related questions
- Complete wage statements, as needed
- Provide re-prints of certificates of insurance to field teams
- Assist Risk Management Generalist and Manager of Insurance & Claims as required for insurance renewals, audits, data analysis, etc
- Understanding of insurance coverages related to Worker’s Compensation, Auto Liability and General Liability coverages
- Proficient in Microsoft Office Suite, carrier hosted claim systems and other RMIS systems
- 5+ years of claims and insurance experience
20
Insurance Claims Reviewer Resume Examples & Samples
- Works under immediate supervision
- Initially tasks are basic and routine, more experienced associates will perform tasks that are moderate in complexity and often non-routine
- Initially works in a single client /functional environment due to limited knowledge and skill set. More experienced associates will work in a multi-client or multi-functional environment
- Researches items received via faxes, reports, tasks/client referrals, correspondence, and refund/return checks. Makes appropriate telephone calls to resolve issue
- Follows client’s standard policies and procedures as a guide for accurately applying loss drafts processes and resolving customer inquiries
- At the direction of management, will handle some customer service calls and other temporary assignments. Such assignments may be made with short notice and last for an indefinite period of time
21
Insurance Claims Analyst Resume Examples & Samples
- And assigned legal counsel
- Tracks the recovery of DPS self-insured losses from responsible third parties
- Three or more years of relevant experience
- Good collaboration and team skills
- Demonstrates initiative and drive for results
- Ability to manage multiple concurrent tasks while meeting deadlines
- Strong customer focus
- Takes full ownership and accountability for actions and outcomes
22
Insurance Claims Consultant Resume Examples & Samples
- End to end claims management
- Settling claims within client service instructions, company guidelines and delegated authority
- Building and developing external business relationships
- Attending client meetings where applicable
- Preparing Standard Client Reports within Service Instructions as required
- Achieve monthly productivity level as designated by management
- Comply with relevant legislation such as The General Insurance Code of Practice, and other relevant legislation / regulations and policy requirements
- Resolve complaints in accordance with company guidelines
- Identify opportunities for process improvement
- Identify potential fraud/recovery indicators for claims where applicable
23
Head of Insurance & Claims Internal Audit Resume Examples & Samples
- Leading the North America Insurance and Claims internal audit functions
- Developing comprehensive multi-year internal audit plans incorporating business process, business risks and best practices in internal audit, including reassessment and reprioritization of audits based on an ongoing risk assessment of organizational, business or system changes
- Providing strategic leadership for Insurance (North America) and Claims internal audits for XLC, ensuring the best overall quality of all audit outputs, including project planning/risk assessment documents, field work/testing work papers, and audit reports/results memos
- Providing ongoing quality assurance within the audit process by continuously interacting with audit teams and reviewing audit outputs
- Leading efforts to implement effective risk management initiatives and control improvement efforts that are responsive to changing business needs. Looks to continuously improve the competency of audit team members and others by
- Presenting relevant topics at XLC sponsored events and industry or professional seminars
- Developing XLC Internal Audit Information Management guidance
- Publishing articles in XLC or external publications
- Maintaining awareness for possible or known emerging risks and sharing these perspectives with others
- Adhering to divisional and other external, professional auditing standards (e.g., IIA professional standards)
- Establishing effective senior management relationships and demonstrating a strong understanding of the business
- Developing a leadership role, as a key member of the Internal Audit management team, managing, training and developing internal audit staff. Mentoring and coaching assigned staff as a career development manager
- Participating in major business initiatives and pro-actively advises and assists the business on change initiatives
- Seasoned audit leader in the Property & Casualty (P&C) arena – internally and/or externally. Preferred knowledge of insurance, reinsurance and claims
- Knowledge of Sarbanes-Oxley Act requirements – Section 404 in particular
- Deep experience with risk-based and business process focused audit approach
- Demonstrated leadership in managing audit teams and projects
- Successful experience interacting with members of senior management
- CPA, CIA, ACA, and/or CA designation preferred. BA/BS degree in Accounting, Auditing or Business
- Ability to travel to domestic and international locations when required
24
American Express Insurance Claims Representative Resume Examples & Samples
- Employment eligibility to work with American Express in the U.S. is required as the company will not pursue visa sponsorship for these positions.*
- Insurance industry experience preferred, particularly within claims administration
- Excellent verbal, written and interpersonal communication skills
- Ability to adapt to multiple demands, shifting priorities and rapid changes in workflow
- Ability to demonstrate initiative with minimal supervision to drive results
- Strong problem solving skills, time management and organizational skills
- Superior level of accuracy and attention to detail
- Strong proficiency in PC skills, including MS Word and Excel
- Positive and outgoing personality that is willing to continue learning and growing within the Organization
25
Insurance Claims Manager Resume Examples & Samples
- Bachelor’s degree or equivalent experience
- 5+ years related experience
- 3+ years leading/managing a team
- Has full supervisory responsibility for a team of Claims Adjusters
- Manages work activities and operations of a large functional area or department
- Provides input to and may develop operational plans and works with Senior Management to ensure
26
Insurance & Claims Manager Resume Examples & Samples
- Management and administration of company’s General Liability Warranty insurance program
- Ability to read and evaluate General Liability coverage under the Warranty program, which will include making decisions regarding determining coverage, and providing recommendations to Director regarding all aspects of the Warranty program
- Review and approve all Divisions’ monthly warranty submissions. Work with in-house attorneys to keep them updated on important claims issues
- Determine appropriate backup documents required for warranty claims and document all claims files accordingly
- Prepare the company’s insurance allocation
- Manage the updating of real and personal property asset information and the maintenance of Builders Risk, Sales models and trailers assets for quarterly reporting to the insurance company
- Responsible for claims reporting to the various insurance carriers and maintaining claims files
- Manage direct relationships with our claims handling service (TPA), be fluent with their systems, be able to request loss runs, report claims, and conduct audits
- Prepare, Create and run monthly and quarterly claim reports from Company’s RMIS (Risk Management Information System), as well as any ad-hoc requested reports, for corporate and division management
- Ensure data integrity by running various reconciliation reports and overseeing audit processes i.e. SOX
- Coordinate all claims procedures and handling of files with newly acquired companies
- Conduct claim reviews and audits on a quarterly basis of our third party administrator
- Assist Director and Risk Manager on overseeing claims as required (this can include but is not limited to property claims, Workers Comp, Environmental, etc)
- Assist the Corporate Litigation Counsel on litigated bodily injury and auto liability matters; familiarity with the litigation process
- Be able to interpret policy language and address deficiencies in all lines of coverage
- Assist Director and Risk Manager with any required daily functions of the Risk Management department, which can include coverage reviews, data analytics, reviewing contract documents, RMIS administration and reports, etc
- Assist Risk Manager where required regarding our Company’s Subcontractor Insurance tracking process, which will include addressing questions from internal and external customers regarding our Company’s insurance requirements
- Assist with compiling exposure data and completing applications required for the Company’s various insurance policy renewals
27
Crop Insurance Claims Associate Resume Examples & Samples
- High School Diploma or Equivalent and no prior experience required in the customer service area
- Zurich approved Apprenticeship program including an Associate Degree and no prior experience required in the customer service area AND
- Claims experience
- Agricultural experience in handling crop line of business
- Customer service background in an office environment
- Analytical and organization skills
- Experience collaborating across work groups
28
Medical Insurance Claims Rep Resume Examples & Samples
- Interpersonal skills - able to work effectively with other employees, patients and external parties
- PC skills - demonstrates proficiency in Excel, Word applications as required
- One to three years experience working in a physician's office, clinic or hospital setting strongly preferred. Collection experience strongly preferred
29
Insurance Claims Analyst Resume Examples & Samples
- Reviews and analyzes mitigation claim reports based on standards including: correct invoicing of line items, psychrometric review of data in the record of drying conditions, correct labor efficiency, price list variation, equipment sizing, etc
- Submits claims within established guidelines for commercial and personal lines clients and insurance customers, and follows up on the status of all claim files with clients and requests monies due on all losses that analyst processes
- Communicates expectations of file quality to franchisees including completeness and accuracy of Record of Drying conditions according to the S-500 standards established by the Institute of Inspection, Cleaning and Restoration Certification. Corresponds with franchisees, 866RECOVER (end user) clients, agents, policy holders, and insurance companies on claims and payment status
- Records billed items into the system and verifies JDEdwards Aging Accuracy
- Assists with process improvement and creation of standard operating procedures to better meet client requirements
- Produces and distributes weekly and monthly reports
- Bachelor degree and/or 2+ years relevant experience
- Ability to manage work flow efficiently (time management)
- Detail oriented when analyzing claims
- Ability to multi-task effectively
- Ability to follow processes and have great follow through skills
- Good communication skills, both written and verbal
- Ability to interact with internal and external customers in a positive manner
- Ability to work independently
30
Insurance Claims Examiner Resume Examples & Samples
- Claims worked will primarily involve health, or disability type of insurance products. Determine claim processing protocols and apply the correct policies to the claim
- Interact with customers and internal departments to resolve issues and accurately process claims
- Properly adjudicate claims based on your knowledge of covered benefits, insurance and provider contracts
- Apply understanding of advanced principles, theories, and concepts as well as related knowledge to solve problems and deliver solutions
- Monday-Friday schedule 8am to 5pm or similar
31
Insurance Claims Assistant Resume Examples & Samples
- Contact the injured party promptly to obtain information necessary to investigate the claim
- Conduct a prompt and fair investigation and fact evaluation of the incident. Dispose of the claim in a timely manner by accepting or denying it. Provide customer with a detailed explanation if the claim is to be denied
- Create and implement action plans for case resolution, litigation management, negotiation and disposition in consultation with Defense Counsel
- Pursue subrogation where applicable
- Work with the safety manager if dangerous issues are identified at a location
- Handle customer complaints with respect to a wide range of issues
- 2 years experience in legal, workers compensation, general liability customer service or insurance related fields. Legal or legal department is preferred
32
Insurance Claims Administrator Resume Examples & Samples
- Responsible for dealing with all new property insurance damage claims and collating appropriate documentation including; stock lists, repair costs etc
- Setting up insurance claim files, entering details onto a database and following claims through to completion
- Maintaining the Claims database to ensure all information is relevant and accurate
- Responsible for liasing with stores and external parties (including insurers, brokers, loss adjusters and third party claims administrators) to reach satisfactory conclusion to property insurance claims and maximise monies recovered from third parties
- Assisting the Group Insurance Manager to determine ways to speed up and settle claims
- Providing various analysis/reports and management information to help the department manage insurance claims recoveries
- Dealing with day- to day queries via telephone and email
- Working as part of the Group Risk team, supporting other team members with various administrative responsibilities
- Gathering evidence to support the pursuit or defence of related claims
- Strong communication skills, including a professional and confident manner
- Excellent organisational ability and capable of prioritising
- Ability to manage a high volume workload
- Good PC skills – particularly Microsoft Outlook, Excel and Word
- Flexible approach to work – capable of offering support to the wider team when required
- Previous Insurance experience is not essential as full training will be provided
33
Insurance & Claims Manager Resume Examples & Samples
- A solid educational background (Bachelors or Master’s degree preferably with a legal specialization)
- At least five years of experience in the (international) insurance market; as a customer, a broker or insurance company. You have achieved the relevant Insurance qualifications (i.e. Assurantie A, Wft schade) and you have proven experience in negotiating and administering large complex claims. Experience with consumer product liability and other liability claims as well as good working knowledge of all types of Insurance is an advantage
- Your negotiation skills include strategic and tactical thinking, which enables you to be ahead of the game
- You have outstanding social skills. It is your nature to investigate underlying motives and take nothing for granted. Your communication skills are of an excellent level and you are fluent in English. You show and demonstrate both diplomacy and sharpness
- You are a well-balanced and firm personality
- You are focused on goals and results, and you don’t walk away from operational issues and responsibilities. Furthermore you are an out‐going person, with a can –do‐attitude with whom people like to work with (team player)
- You are willing to travel from time to time abroad
- Beyond these role specific attributes, you are an open minded, proactive and enthusiastic team player focused on results and client service
34
Business Analyst With Insurance Claims Experience Resume Examples & Samples
- Must have recent Insurance industry experience- specifially Claims
- 2-3+ years of experience as a Business Analyst
- Work cross functionally between various teams; business and development groups
- Gather requirements, create functional requirements
- Experience supporting SDLC/app dev projects- basic technical familiarity
- Understands business strategies and stays abreast of industry trends in the business and technology
- Strong relationship building, communications, negotiations, influencing, and analytical skills
- Bachelor's degree in related area (Computer Science, Information Systems or other related field) or an equivalent combination of education and experience
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Heath Insurance Claims Representative Resume Examples & Samples
- 1 year work experience required-Health Care
- Strong typing skills with speed and accuracy
- Team-oriented while also able to pursue personal and
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Insurance Claims Processor Resume Examples & Samples
- A competitive hourly pay rate with weekly checks
- Online continuing education via the Kelly Learning Center
- Several employee discounts
- And more!
- Responsible for sorting and routing customer and provider claims or inquires to the appropriate areas within and outside the company
- Will prepare various claims for entry and ensure all claims are complete and prepares letters to be sent to both members and providers
- Effectively communicates using verbal and written skills with peers, internal and external customers
- Ability to work in a fast pace and high production environment
- Ensure all claims are complete and prepares letters to be sent to both members and providers
- Research errors on claims and provides resolution to allow the claim to be entered into the processing system appropriately
- As needed, responsible for the entry, investigation, triage and analysis of basic claims
- Completes daily reporting of receipts, production, aging and inventories
- With this specific role, regular attendance is a necessity
- Medical Claim knowledge strongly preferred
- Exposure to a variety of career opportunities as a result of our expansive network of client companies
- Weekly pay and service bonus plans
- Group- rate insurance options available immediately upon hire*
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Senior Insurance Claims Analyst Resume Examples & Samples
- Development and implementation of improvements to TPA and Claims Management Programs
- Provide oversight and direction to department claim staff
- Provide ongoing training and development to department claim staff
- Provide oversight, direction and authority to DPS Third Party Claims Administrators
- Monitor performance and participate in periodic reviews of Third Party Claims Administrators against established DPS service requirements
- Review insurance policies to establish and confirm coverage for claims
- Work with insurance brokers and insurance companies to address and resolve coverage issues
- Ensure timely and accurate reporting of claims to DPS insurers in compliance with insurance policy terms and conditions
- Assist and work with DPS business units to collect and furnish data and information required by insurers to document and support DPS claims
- Negotiate and settle DPS claims with insurance carriers within established authority
- Develop relationships with DPS business units to educate, support and assist with programs and initiatives to reduce total cost of risk
- Provide claims data and reports to business units to assist them in managing and improving their loss experience
- 6-10 years of relevant experience
- Bachelor’s degree in business or risk management is desired
- Carrier and or TPA experience
- Demonstrates transparency and honesty in all interactions and activities
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Senior Analyst, Insurance Claims Resume Examples & Samples
- Work to protect Smucker Brands, Assets, and Employees
- Be a key member of the Risk Management Department and assist the Department to operate efficiently and effectively in the service of our internal and external customers
- Aggressively manage claims for multiple lines of insurance such as Workers Compensation, GL, Auto, Property, Ocean Cargo, Transit, etc
- Accumulate and analyze data for monthly, quarterly and ad hoc report outs on losses and loss trends
- Drive departmental loss analytics
- Work with our plants, business units, Legal, Health, Safety and Environmental teams, insurance brokers, and Third Party Administrators to close and mitigate current losses and prevent future losses
- Analysis of historical loss data to drive program improvements and predictive modeling
- A minimum of 4 years of proven insurance claims handling expertise necessary to drive a claim from initial opening and noticing through to satisfactory closure is required
- The vast majority of claims handled will be multi state Workers Compensation in both insured and self-insured arenas. The ideal candidate will have proven expertise in handling multi state Workers Compensation claims in a manufacturing environment
- The ideal candidate will also have experience with other lines of insurance in addition to Workers Compensation
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Insurance Claims Processor Resume Examples & Samples
- Ability to maneuver between multiple screens
- Accuracy
- Ability to adapt well to change
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Insurance Claims Manager Resume Examples & Samples
- Performs validation of claims submitted to the insurance carriers in the Managed Mitigation Program (MMP) including: validation of equipment sizing and correct invoicing of line items, correctly noted equipment placement, water flow, and psychometric review of data to show grain depression in the record of drying conditions, etc
- Manages the day to day activities of the Managed Mitigation Program and serves as the escalation point and subject matter expert
- Assists team in meeting set objectives and goals, while maintaining budget requirements
- Travels as needed to build and maintain key insurance relationships to ensure compliance to current claims review program and the development of ideas of how to continually improve and expand the relationship with the customer
- Manages multiple complex projects/business process improvement initiatives simultaneously
- Assists with data gathering and process improvement
- Compiles and analyzes call handling statistics and maintains all franchise lead dispute process completion and statistics
- Provides support and communication to Disaster Restoration team, Regional management team and approximately 650 participating QRV franchises
- Communicates with vendor to provide job knowledge and productivity consistency
- Coordinates with IT on software changes and additions
- Develops communication and training material related to RESPOND/866RECOVER
- Recommends efficiency improvements for the Claims Capture Unit
- Presents claims-related overview and training to the QRV academy
- Bachelor degree and/or 4+ years of relevant experience in management, operations, or call center experience
- Ability to autonomously work on multiple, complex and highly important business projects
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Supervisor Mortgage Insurance Claims Resume Examples & Samples
- Develop, maintain and execute the Mortgage Insurance quality assurance program to ensure compliance with all Navy Federal, Investors and state and federal regulations/guidelines
- Supervise quality control monitoring of insurance outsourcing vendor to ensure compliance and policy adherence, including documenting quality control and reviewing of vendor controls
- Oversee vendor management of the key service provider
- Oversee correction/resolution of non-compliance issues detected to meet internal quality control standards
- Oversee reconciliation process and ensure insurance premium refunds and billing discrepancies are processed appropriately
- Monitor account payable general ledger reports to ensure all outstanding checks are cleared in the appropriate timeframe and payments are made to our insurance carriers
- Ensure changes affecting members mortgage insurance coverage are accurately reflected within the mortgage servicing system and processed accordingly
- Coordinate mortgage insurance quality control service standards and procedures with Call Center Operations
- Monitor changes in mortgage insurance rules and regulations and communicate to staff
- Supervise the responses to electronic and Web online e-messages, written, and telephone communications from member and non-members (i.e. regulators, Investors, vendors)
- Establish qualitative and quantitative measures to meet compliance and mortgage servicing goals and expectations
- Review production and exception reports to identify and resolve exceptions; adjust work assignments to meet work volume fluctuations
- Monitor or develop safeguards to ensure data integrity of vendors
- Guide process improvement and system enhancement projects and initiatives
- Serve on the Mortgage Servicing System Functional Advisory Committee
- Perform supervisory/managerial responsibilities - Ensure adequate/skilled staffing; select employees - Establish performance goals and priorities - Prepare, conduct and review performance appraisals - Develop, mentor and counsel staff - Provide input and/or prepare budget requirements for Annual Financial Plan (AFP) - Ensure section/branch goals and objectives align with division/department strategy - Ensure efficiency of operations - Leadership Level
- Perform other duties as assigned or appropriate
- Bachelor’s Degree in Business, Finance or related field or equivalent education/experience
- Knowledge of Navy Federal objectives, policies & procedures, organizational and functional relationships
- Mortgage Servicing System (i.e. BKFS) experience preferred
- Experience applying techniques used in analyzing and reporting financial reporting information
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Insurance Claims Coordinator Resume Examples & Samples
- Support the Global Insurance & Enterprise Risk Department
- Assist in preparing market submissions including the gathering and analysis of underwriting data
- Maintain SharePoint site including document filing & document retention
- Monitor department email addresses for action items
- Assist in issuing certificates of insurance, including tracking and renewal
- Assist in quote generation and sales cycle for internal insurance programs
- Support, document, and maintain up to date claims files
- Support claims adjusting function
- Responsible for COUPA invoice entry
- Maintain insurance related expense bordereau as it relates to claims files
- Support management with various monthly reports
- Participate and contribute in various departmental projects
- Participate in premium allocation
- Coordinate department meetings as required by team members
- Actively participate, contribute and deliver on the strategic objectives of the department
- General administrative duties as required
- Any other ad hoc duties as assigned
- Preference given to those with at least 2 years of insurance and/or finance related experience
- Highly proficient in Power Point
- Highly proficient in Excel, including modelling complex graphs derived from data sets
- Highly detail oriented
- Capable of multi-tasking
- Proven track record to excel at working independently or with minimal supervision
- Able to respond quickly and efficiently to last minute requests and respect deadlines
- Excellent spoken and written communication skills
- Willing to further education as required
- Strong desire to learn more about the global risk management industry
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Insurance Claims Auditor Resume Examples & Samples
- Read and analyze EOB’s and make proper adjustments according to PDS claims processing criteria
- Sends appeals to insurance carriers with justification as to why dental treatment should be paid
- Audit accounts to ensure proper fees have been posted
- Works with CBO team to maximize office collections and minimize adjustments
- Communicate issues and suggestions to improve processes
- Ensure compliance with Company policies as well as State, Federal and other regulatory bodies
- Participate in meetings as required
- Maintain an appropriate professional appearance and demeanor in accordance with Company policy
- Equivalent to high school diploma or general education degree (GED)
- 3-4 Years of related experience in the dental field
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Insurance Claims Representative Resume Examples & Samples
- Plan, recommend, and execute the investigation and disposition of claims consistent with corporate claim standards policies and procedures, and statutory, regulatory and ethics requirements
- Manage caseload/claims within established performance standards
- Establish and maintain effective relationships with customers, gaining their trust and respect
- A passion for customer service
- Demonstrated ability to effectively communicate
- Desire to advance your career and continuously improve
- Willingness to learn, lead, be led, support others, have fun and work hard
- Bachelor’s Degree preferred
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Business Insurance Claims Associate Resume Examples & Samples
- Quickly incorporate technological advances that enhance productivity and service
- Handle special projects as needed
- Provide excellent customer service and communication skills
- Behighly professional with excellent verbal and written communication skills
- May perform other related duties as assigned
- Prior insurance experience is preferred
- Highly professional with excellent verbal and written communication skills
